2021-05-11T16:08:33-05:00 2020-06-30 420714325 RSM US LLP 30 South Wacker Dr Suite 3300 Chicago IL 606063392 990 2019-07-01 362181961 Brethren Home BRET 8157344103 414 South Wesley Avenue Mount Morris IL 61054 Ferol Labash Chief Executive Officer 8157344103 2021-05-06 1 Rebekuh Eley P01247672 3126343400 2021-05-06 2019 2022-09-23 18:48:47Z Ferol Labash 414 South Wesley Avenue Mount Morris IL 61054 13591450 0 X www.pinecrestcommunity.org X 1961 IL Brethren Home is a continuing care retirement community providing quality residential and health services. Brethren Home seeks to promote an active retirement and healthy lifestyle with respect, dignity and security for the whole person. 14 14 255 14 0 0 721367 613257 9924672 10622562 133154 66207 74385 70770 10853578 11372796 1317 0 0 0 6968709 7947852 0 0 0 3862820 4111060 10832846 12058912 20732 -686116 13841612 14265140 5452497 6635485 8389115 7629655 Brethren Home is a continuing care retirement community providing quality residential and health services. Brethren Home seeks to promote an active retirement and healthy lifestyle with respect, dignity and security for the whole person. 0 0 8564047 0 10059762 Brethren Home owns and operates a long-term care facility with a total bed capacity of 125 as of June 30, 2020. 562800 0 562800 Brethren Home provides administrative services to Pinecrest Grove and Pinecrest Village. 9126847 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 31 0 1 255 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 IL X Ferol Labash 8157344103 414 South Wesley Avenue Mount Morris IL 61054 Ferol Labash Chief Executive Officer 40.00 0.90 X 106918 0 4367 Andrew Welp President 0.30 0.90 X X 0 0 0 Gary Henderson Vice President 0.30 0.90 X X 0 0 0 Mike Anderson Treasurer 0.30 0.90 X X 0 0 0 Dianne Swingel Secretary 0.30 0.90 X X 0 0 0 Roger Anna Director 0.30 0.90 X 0 0 0 Dr Edward Baker Director 0.30 0.90 X 0 0 0 Patricia Ball Director 0.30 0.90 X 0 0 0 Beverly Binkley Director 0.30 0.90 X 0 0 0 Neil Brinkmeier Director 0.30 0.90 X 0 0 0 Gerald Kinsley Director 0.30 0.90 X 0 0 0 Gary Melvin Director 0.30 0.90 X 0 0 0 Patrice Nightingale Director 0.30 0.90 X 0 0 0 Brenda Nevenhoven Director 0.30 0.90 X 0 0 0 Kurt Zuck Director 0.30 0.90 X 0 0 0 106918 0 4367 1 0 0 0 Premere Rehab LLC 25117 SW Parkway Suite D Wilsonville OR 97070 Rehabilitation Services 607371 Martin Brother Distributing Co Inc 406 Viking Road Cedar Falls IA 50613 Distribution Services 501938 RSM US LLP 30 South Wacker Dr Suite 3300 Chicago IL 60606 Accounting Services 115910 Loescher Heating & Air Conditioning Corp 1860 S Walnut Road Freeport IL 61032 HVAC Services 114182 Gesin Inc 207 N McKendrie Avenue Mt Morris IL 61054 Construction Services 110615 5 92025 69325 451907 75000 613257 Nursing home fees 623000 10059732 10059732 Management fees 561000 562800 562800 30 30 10622562 56242 56242 2228619 2218654 9965 9965 9965 Vending Machine 453000 38475 38475 Beauty Shop 812900 27622 27622 4673 4673 70770 11372796 10622562 0 136977 111225 111225 6505874 5833042 672832 96081 84696 11385 743189 655129 88060 491483 433247 58236 741105 609096 132009 10646 10646 229367 20011 209356 185805 185805 375365 259612 115753 7509 7509 9005 9005 169177 18900 150277 347811 260179 87632 135437 97595 37842 Bad Debt Expense 691412 691412 Food 433677 433677 Medical Supplies 375161 375161 Assessment Fees 266841 266841 132742 46502 86240 12058912 9126847 2932065 0 325546 1175718 1197341 1299232 30125 36781 120382 145356 13945098 9221513 4871991 4723585 1861255 1083444 5434972 5801024 13841612 14265140 1576689 1432416 0 479561 3422321 3319249 281274 1158843 172213 245416 5452497 6635485 X 7834288 7040438 554827 589217 8389115 7629655 13841612 14265140 -686116 -73344 0 X 0 1 X 1 0 X 671613 876344 203418 721367 613257 3085999 8917214 9409565 9442011 9924672 10622562 48316024 59611 63316 64660 72456 66097 326140 9648438 10349225 9710089 10718495 11301916 51728163 5000 5000 10849 20849 3171 3171 5000 5000 14020 24020 51704143 95746 53403 75480 84745 56242 365616 95746 53403 75480 84745 56242 365616 879 2264 31698 1929 4673 41443 9745063 10404892 9817267 10805169 11362831 52135222 0.99170 0.98860 0.00700 0.01050 X Schedule A, Part III, Line 12, Explanation of Other Income: Miscellaneous - 2015 Amount: $ 879. 2016 Amount: $ 2,264. 2018 Amount: $ 1,929. 2019 Amount: $ 4,673. Legal Settlement - 2017 Amount: $ 31,698. 2018 Amount: $ 0. 2019 Amount: $ 0. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 325602 6862 6862 325602 325602 6995 6995 325602 325602 5620 5620 325602 325602 5967 5967 325602 325602 10356 10356 325602 0.00000 1.00000 0.00000 1 0 95626 95626 10608598 6350516 4258082 2025421 1805727 219694 1215453 1065270 150183 4723585 Restricted deposits and funded reserves 55120 Captive insurance investment 495840 Endowment trust - permanently restricted 325602 Due from related parties 4914948 Board designated for capital 9514 5801024 Resident Credit Balances 245416 245416 X Part V, Line 4: The organization does not have a spending policy relating to its endowment funds; however, historically the Board of Directors has authorized the spending of earnings on the endowment funds in a timely manner for purposes consistent with the mission of the organization. Part X, Line 2: Brethren Home files Form 990, Return of Organization Exempt from Income Tax, annually. When this return is filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. Unrelated business income (UBI) is reported on Form 990-T, as appropriate. The benefit of a tax position is recognized in the consolidated financial statements in the period during which, based on all available evidence, management believes that it is more likely than not that the position will be sustained upon examination, including the resolution of appeals or litigation processes, if any. Tax positions are not offset or aggregated with other positions. Tax positions that meet the "more likely than not" recognition threshold are measured as the largest amount of tax benefit that is more than 50 percent likely to be realized on settlement with the applicable taxing authority. The portion of the benefits associated with tax positions taken that exceeds the amount measured as described above is reflected as a liability for unrecognized tax benefits in the accompanying consolidated statements of financial position along with any associated interest and penalties that would be payable to the taxing authorities upon examination. As of June 30, 2020 and 2019, there were no unrecognized tax benefits identified and recorded as liabilities. Form 990 filed by Brethren Home is subject to examination by the IRS up to three years from the extended due date of the return. Forms 990 filed by Brethren Home are no longer subject to examination for the years ended June 30, 2016 and prior. A Village of Mt Morris Illinois 366006010 Noneavail 2013-08-01 3927350 Refund 2008 Bonds 0 0 0 A 608101 3927350 3927350 2013 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 1 0 1 0 0 0 0 A 0 X 1 75000 Book Value 0 0 0 0 Part I, Column (b): Is the number of contributions received. Form 990, Part VI, Section A, line 6 Each residential congregation, recognized fellowship and specialized ministry within the jurisdiction of the District of Illinois and Wisconsin, Church of the Brethren, shall be considered a member. Form 990, Part VI, Section A, line 7a Each congregation, fellowship or specialized ministry in the IL/WI District of the Church of the Brethren names a delegate to the District meeting which is held annually. The delegates represent their home church and vote on the business of the District. During that District meeting, they close the regular meeting and open the annual meeting of Pinecrest. The CEO provides a written report, gives a verbal report and provide copies of our yearly financial statements to the delegates. The delegates are given an opportunity to ask questions to the CEO and then close the annual meeting of Pinecrest and reopen the District meeting. They do this for each of the District's nursing homes and church camps. During the business meeting of the District, they approve any new Pinecrest Board members who are also Church of the Brethren members. They also approve any Pinecrest Board members who are entering a second or third term on the Board who are Church of the Brethren members. Form 990, Part VI, Section B, line 11b Ferol Labash, CEO, reviewed the Form 990 carefully. The Form 990 was presented at the Board of Director's meeting and was reviewed and approved by the Board before it was filed. Form 990, Part VI, Section B, line 12c The officers and Board of Directors are required to sign a conflict of interest policy form before they become the board members. The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy by reviewing it annually. Each board member completes a conflict of interest questionnaire annually stating they have read the policy and disclosing any potential conflicts of interest. The questionnaires are reviewed by the compliance officer and CEO. If a conflict arises, the board would be made aware of the conflict. The board member with the conflict would not participate in any discussion or vote related to the conflict. Form 990, Part VI, Section B, line 15a The salary for the CEO is discussed at the Executive Board meeting once a year. The board uses their judgment as well as the Leading Age published wage survey. Leading Age is an Illinois association whose membership is made of nursing facilities within the state. The process and decision is contemporaneously documented. Form 990, Part VI, Section C, line 19 Governing documents, conflict of interest policy and financial statements are available upon written or verbal request for the same period of disclosure as set forth in IRC Section 6104(d). Pinecrest Grove 414 South Wesley Avenue Mount Morris IL 61054 320158623 Administration of senior citizen residential property IL 501(c)(3) Line 10 Church of the Brethren 1 Pinecrest Village 414 South Wesley Avenue Mount Morris IL 61054 363489747 Continuing care retirement community IL 501(c)(3) Line 10 Church of the Brethren 1 Pinecrest Foundation 414 South Wesley Mount Morris IL 61054 363782988 To raise, receive and administer funds for the benefit of elderly IL 501(c)(3) Line 12d, III-O Church of the Brethren 1 Church of the Brethren 1451 Dundee Avenue Elgin IL 60120 362167026 Church IL 501(c)(3) Line 1 N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 Pinecrest Village L 484800 Value of Services Rendered Pinecrest Grove L 78000 Value of Services Rendered Pinecrest Foundation C 75000 Book Value